South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Snakebites occur in the community, not in the Emergency Unit. As such it is important to understand the first-aid concepts and pre-hospital emergency care aspects of this neglected disease. This article will highlight the concepts for emergency care within the context of the current pre-hospital arena and in light of the recent South African Snakebite Symposium consensus meeting held in July 2022, where wilderness rescue, emergency medical services and other medical participants agreed through evidence review and consensus debate on the current best approaches to care of the snakebite victim outside the hospital environment.
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Tygerberg Hospital (TBH) is a tertiary-level hospital in Western Cape Province, South Africa, that provides healthcare to a large low- to middle-income population with services including centralised advanced cardiac care. Acute coronary syndrome (ACS) remains an important cause of death in the region despite a high burden of communicable diseases, including HIV. ⋯ Use of a guideline-based approach to treating ACS in a low- to middle-income country setting yields mortality rates comparable to those in high-income countries. However, the lower-than-expected incidence rates of both STEMI and HR-NSTEACS in a relatively young population with a high prevalence of traditional cardiovascular risk factors, and a relatively high proportion of STEMI, suggest potential under-recording of ischaemic heart disease in the region. The rate and outcomes of coronary artery disease (CAD) in people living with HIV were similar to those in people without HIV, suggesting that traditional risk factors still drive CAD outcomes in the region.
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This is the introduction article and editorial that will address the latest approaches to safe management of snakebite in South Africa and shares the evidence and expert consensus from the recent South African Snakebite Symposium (SASS) meeting held in July 2022.
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The South African (SA) medical internship training programme model was recently revised to extend training into the primary care platform. In this article, we reflect on the experiences of training under the new model from an intern perspective. We use these reflections to make recommendations to the Health Professions Council of SA on how to further improve the training model by implementing systems that guide and empower the intern doctor practising at a primary level of care.